scholarly journals Spot Urine Protein Excretion in the First Year Following Kidney Transplantation Associates With Allograft Rejection Phenotype at 1-Year Surveillance Biopsies: An Observational National-Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Manca Oblak ◽  
Gregor Mlinšek ◽  
Nika Kojc ◽  
Maja Frelih ◽  
Jadranka Buturović-Ponikvar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Allograft Rejection ◽  
De Novo ◽  
First Year ◽  
Urine Protein ◽  
Spot Urine ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Significant Difference ◽  
National Cohort

Introduction: Urine protein excretion is routinely measured to assess kidney allograft injury, but the diagnostic value of this measurement for kidney transplant pathology remains unclear. Here we investigated whether spot urine protein excretion in the first year following transplantation associates with allograft rejection phenotype at 1-year surveillance biopsies and de-novo occurrence of donor-specific antibodies (DSA).Patients and Methods: This prospective, observational national-cohort study included 139 non-sensitized patients who received a deceased donor kidney transplant between December 2014 and 2018. All patients received basiliximab induction and tacrolimus-based immunosuppression. Estimated protein excretion rate (ePER) was calculated monthly from spot urine protein-to-creatinine ratios. At 1-year, all recipients underwent surveillance graft biopsy and were screened for de-novo DSA. Screening-positive sera were subjected to single antigen bead (SAB) testing. The occurrence of de-novo DSA was determined based on SAB reactivity patterns using a mean fluorescence intensity threshold >1,000.Results: Among the 139 study patients, 27 patients (19%) had histologic evidence of T cell-mediated rejection (TCMR), and 9 patients (7%) had histologic evidence of antibody-mediated rejection (AMR) at 1-year surveillance biopsy. One year after transplant, 19 patients (14%) developed de-novo DSA. Compared with patients without rejection and no de-novo DSA, mixed-effects linear regression analysis showed a significant difference in slope of ePER during the first year in patients with AMR and de-novo DSA at 1-year (46, 95% CI 25–68 mg/day/1.73 m2 per month and 34, 95% CI 20–49 mg/day/1.73 m2 per month, respectively). Patients with vascular TCMR also showed a significant difference in ePER slope over time compared with patients with non-rejection findings (31, 95% CI 9–52 mg/day/1.73 m2 per month). The discriminatory power of ePER for intragraft rejection processes was better in patients with AMR (AUC 0.95, 95% CI 0.90–0.99; P < 0.001) than in those with TCMR (AUC 0.68, 95% CI 0.59–0.79; P = 0.002), with 89% sensitivity and 93% specificity for proteinuria >550 mg/day/1.73m2.Conclusions: An increase in ePER in the first year following kidney transplantation associates with AMR, vascular TCMR and de-novo DSA at 1-year and may be used as a non-invasive clinical marker of intragraft endothelial cell injury.

scholarly journals Comparative study of 24-hour urinary protein and spot urine protein creatinine ratio in pre-eclamptic women

2021 ◽  
Vol 10 (7) ◽  
pp. 2734
Author(s):  
Rupakala B. M. ◽  
Akshata S. Hiremath
Keyword(s):  
Predictive Value ◽  
Urinary Protein ◽  
Creatinine Ratio ◽  
Spearman Correlation ◽  
Urine Protein ◽  
Spot Urine ◽  
Medical College ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Urine Specimens

Background: The aim of the study was to evaluate the ability of the random urine P/C ratio to predict significant proteinuria, as well as to introduce a diagnostic test for pre-eclampsia which will avoid the inconvenience and time consumption of 24-hour urine protein collection. The objective of this study was to compare spot urine protein- creatinine ratio with 24-hour urine protein for estimation of proteinuria in pre-eclampsia.Methods: A total of 50 pregnant women with pre-eclampsia were prospectively studied for proteinuria in Rajarajeswari medical college and Hospital Bangalore for a period of 9 months from September 2018 to May 2019. Spot urine specimens for measuring P/C ratio were obtained immediately before 24-hour urine collection. The correlation between the spot urine P/C ratio and urinary protein excretion in the 24-hour collections was examined using the Spearman correlation test.Results: PCR at a cut off value 0.15 g/mmol had sensitivity and specificity of 96.6% and 55% respectively. In prediction of proteinuria of 300 mg/24 hr positive predictive value and negative predictive value 76.3% and 91.6% respectively.Conclusions: We found that there was a strong correlation between 24-hour urine protein excretion and spot urine protein creatinine ratio in pre-eclamptic women. Spot PCR can be used as a reasonable alternative to 24-hour urine protein test which is a cumbersome.

scholarly journals Spot Urine Estimations Are Equivalent to 24-Hour Urine Assessments of Urine Protein Excretion for Predicting Clinical Outcomes

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Boon Wee Teo ◽  
Ping Tyug Loh ◽  
Weng Kin Wong ◽  
Peh Joo Ho ◽  
Kwok Pui Choi ◽  
...  
Keyword(s):  
Regression Models ◽  
Proportional Hazards ◽  
Predictive Performance ◽  
Linear Regression Models ◽  
Urine Protein ◽  
Proportional Hazards Models ◽  
Spot Urine ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Gfr Decline

Background. The use of spot urine protein to creatinine ratios in estimating 24 hr urine protein excretion rates for diagnosing and managing chronic kidney disease (CKD) predated the standardization of creatinine assays. The comparative predictive performance of spot urine ratios and 24 hr urine collections (of albumin or protein) for the clinical outcomes of CKD progression, end-stage renal disease (ESRD), and mortality in Asians is unclear. We compared 4 methods of assessing urine protein excretion in a multiethnic population of CKD patients.Methods. Patients with CKD (n=232) provided 24 hr urine collections followed by spot urine samples the next morning. We created multiple linear regression models to assess the factors associated with GFR decline (median follow-up: 37 months, IQR 26–41) and constructed Cox proportional-hazards models for predicting the combined outcome of ESRD and death.Results. The linear regression models showed that 24 hr urine protein excretion was most predictive of GFR decline but all other methods were similar. For the combined outcomes of ESRD and death, the proportional hazards models had similar predictive performance.Conclusions. We showed that all methods of assessments were comparable for clinical end-points, and any method can be used in clinical practice or research.

scholarly journals Spot urine protein measurements in normotensive pregnancies, pregnancies with isolated proteinuria and preeclampsia

2017 ◽  
Vol 313 (4) ◽  
pp. R418-R424 ◽  
Author(s):  
Andrea Kattah ◽  
Natasa Milic ◽  
Wendy White ◽  
Vesna Garovic
Keyword(s):  
Blood Pressure ◽  
Abrupt Onset ◽  
Urine Protein ◽  
Prospective Longitudinal Study ◽  
Spot Urine ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Blood Pressures ◽  
Prospective Longitudinal ◽  
Isolated Proteinuria

We performed a prospective, longitudinal study of pregnant women presenting to their first obstetrics visits to characterize the changes in spot urine protein-to-creatinine (UPCR) and albumin-to-creatinine ratios (UACR) in normotensive pregnancies, as well as identify clinical characteristics associated with isolated proteinuria and preeclampsia. We measured spot urinary albumin, protein, and creatinine at the first prenatal visit, end of the second trimester, and at delivery. In the normotensive pregnancies ( n = 142), we found that from the beginning of pregnancy to delivery, UACR increased by a median [interquartile range (IQR)] of 14.7 mg/g Cr (3.74–51.8) and UPCR by 60 mg/g Cr (30–130) ( P < 0.001 for both changes). Isolated proteinuria (defined as UPCR > 300 mg/g Cr in the absence of hypertension) was identified in 19/142 (13.4%) normotensive pregnancies. Increases in systolic and diastolic blood pressure from early pregnancy to delivery and increases in UACR from early to midpregnancy were associated with isolated proteinuria at delivery. Twelve women developed preeclampsia. Nulliparity, early, and midpregnancy diastolic blood pressures were strongly associated with the development of preeclampsia, but early changes in UACR were not. In conclusion, women who develop isolated proteinuria at delivery have a larger increase in blood pressure than women without proteinuria and have a “microalbuminuric” phase earlier in gestation, unlike women who develop preeclampsia. These findings suggest a different mechanism of urine protein excretion in women with isolated proteinuria as compared with women with preeclampsia, where proteinuria has a more abrupt onset.

Increase in spot urine protein excretion is associated with late kidney graft rejection and predicts rejection phenotype

2017 ◽  
Vol 88 (S1) ◽  
pp. 83-90
Author(s):  
Miha Arnol ◽  
Manca Oblak ◽  
Gregor Mlinšek ◽  
Jelka Lindič ◽  
Aljoša Kandus ◽  
...  
Keyword(s):  
Graft Rejection ◽  
Kidney Graft ◽  
Urine Protein ◽  
Spot Urine ◽  
Urine Protein Excretion ◽  
Protein Excretion

scholarly journals Comparison of urine protein creatinine ratio and 24 hours urine protein in detecting preeclampsia

2019 ◽  
Vol 14 (2) ◽  
pp. 49-53
Author(s):  
Nesuma Sedhain ◽  
Jageshwor Gautam ◽  
Gehanath Baral
Keyword(s):  
Area Under The Curve ◽  
Urinary Protein ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Protein Determination ◽  
Cross Sectional ◽  
Spot Urine ◽  
Urine Protein Excretion ◽  
Protein Excretion

Aim: To assess the diagnostic accuracy of spot urine protein-creatinine ratio for detection of proteinuria in Preeclampsia. Methods: Cross Sectional Descriptive Study was conducted in a total of 38 pregnant women in Paropakar Maternity and Women’s Hospital in study period of 3 month. The correlation between protein- creatinine ratio in spot urine samples and urinary protein excretion in 24-hour collections were analyzed. Results: Comparison of 24 hours urinary protein and protein- creatinine ratio in women with preeclampsia shows a significant correlation (r=0.911, p<0.0001). The cut-off protein-creatinine ratios which gave maximum area under the curve for 300mg protein for 24hrs was 0.27 (sensitivity: 94.6%, specificity: 100%, PPV: 100%, NPV: 33.3%); 2000 mg urine protein excretion was 2.1 (sensitivity and specificity of 100%); 3000mg protein excreted for 24hours was 3.0 (sensitivity: 83.3%, specificity: 92.3%, PPV: 83.3%, NPV: 93.3%. Area under the ROC for 24hours urine total protein of >300mg, >2000mg and >3000mg/day were 0.946 (95%CI 0.873-1.019), 1 (95% CI 1.00-1.00) and 0.957 (95%CI 0.897- 1.016) respectively. Conclusions: Spot urine protein-creatinine ratio is as accurate as to 24 hours urine protein determination of proteinuria in Preeclampsia.

Spot urine protein–creatinine ratio and 24-h urine protein excretion: Diagnostic accuracy in women with pre-eclampsia

2014 ◽  
Vol 4 (1) ◽  
pp. 87-90 ◽  
Author(s):  
Nazli Hossain ◽  
Nazeer Khan ◽  
Nusrat Shah ◽  
Tahira Shah ◽  
Sofia Butt ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Spot Urine ◽  
Urine Protein Excretion ◽  
Protein Excretion
Sign in / Sign up

Export Citation Format

Share Document